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- Acolhimento integral em Centros de Atenção Psicossocial Álcool e Drogas na perspectiva da proteção dos direitos humanosPublication . Boska, Gabriella; Ferreira De Oliveira, Márcia Aparecida; Seabra, PauloEste artigo tem por objetivo avaliar se os resultados do acolhimento integral em Centros de Atenção Psicossocial Álcool e Drogas III (CAPS AD III) atendem aos padrões de qualidade para proteção e respeito dos direitos humanos dos usuários. Desenvolvemos um estudo avaliativo, quantitativo e de desenho longitudinal com 122 usuários acolhidos integralmente em dois CAPS AD III, com follow-up após 14 e 90 dias. Os resultados dos indicadores qualidade de vida, consequências da dependência de substâncias e reabilitação psicossocial, foram posteriormente analisados à luz do referencial QualityRights. Três temas e nove padrões foram avaliados. Quatro padrões foram classificados como alcance total, quatro como alcance parcial e um como alcance iniciado. O direito a usufruir do padrão mais elevado possível de saúde física e mental foi o padrão mais atingido pelo acolhimento integral (tema 2). O direito a exercer a capacidade legal e o direito à liberdade pessoal e segurança foi atendido com algumas fragilidades (tema 3). O direito de viver de forma independente e ser incluído na comunidade, necessita de outros recursos sociais, além do cuidado especializado em saúde mental, para ser melhorado (tema 5).
- Adolescents’ perception about the relationship between self-reported smartphone addiction and emotional and behavioral problems during the COVID-19 pandemicPublication . FREITAS, BRUNA HINNAH BORGES MARTINS DE; Gaíva, Maria Aparecida Munhoz; Bortolini, Juliano; Diogo, PaulaAbstract This study aimed at understanding the adolescents’ perception about the relationship between Self-Reported Smartphone Addiction and Emotional and Behavioral Problems in the COVID-19 pandemic context. The qualitative research was conducted in Brazil with 16 adolescents aged from 15 to 18 years old classified as smartphone addiction by Smartphone Addiction Inventory scale. Data were collected through Focus Group meetings and prepared by means of Bardin’s content analysis. The findings resulted in two categories that describe how adolescents escape from the reality imposed by the COVID-19 pandemic using smartphones and how they perceive the emotional and behavioral changes caused by this addiction. They develop this behavior seeking to alleviate negative emotions and to escape from reality, but this relief is momentary and ineffective, as this addictive relationship proves to accentuate emotional distress.
- Air quality self-management in asthmatic patients with COPD: An integrative review for developing nursing interventions to prevent exacerbationsPublication . Sebastião, Bruna F.; Hortelão, Raquel M.; Granadas, Sara S.; Faria, José M.; Pinto, Joana R.; Rafael Henriques, Helga Marília da SilvaObjectives: Asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) patients experience a lower quality of life, frequent exacerbations, and worse pulmonary function. Environmental management is essential in a complex chronic condition, as pollutant exposure can worsen symptoms and increase morbidity and mortality. We aimed to identify evidence that informs nursing interventions in promoting self-management of air quality in asthmatic people with COPD. Methods: We conducted an integrative review in March of 2023. We searched the databases CINAHL, MEDLINE, Academic Search Complete, Cochrane Database of Systematic Reviews (CDSR), Scopus, Web of Science, Joanna Briggs Institute (JBI) Evidence-Based Practice Database, and Google Scholar. We included articles whose participants were adults with asthma, COPD, or both; the intervention was air quality management and the outcome of any exacerbations. We excluded editorials, letters, commentaries, opinion papers, position papers, study protocols, conference abstracts, and reviews. Data extraction and synthesis were performed, categorizing interventions according to nursing actions. Methodological quality assessment was conducted using the JBI Critical Appraisal Checklist tools. The review protocol was registered at Open Science Framework (https://doi.org/10.17605/OSF.IO/5Y4KW). Results: We included five articles from different countries. The interventions promoting air quality self-management for individuals with asthma and COPD included vigilance interventions (health professional regular visits, assessment of symptoms), monitoring interventions (measurement of indoor and outdoor trigger factors), and educational interventions (air quality alerts, allergen avoidance). Policy interventions such as smoke-free policies and comprehensive strategies to improve air quality were also identified. These areas of focus represent critical components of nurses' interventions and can integrate the fundamental patterns of knowing in nursing. Although the studies reveal heterogeneous interventions and the methodological quality is variable, these interventions showed potential for preventing exacerbations, reducing emergency department visits, and minimizing hospitalizations. Conclusions: The study emphasizes the need for a comprehensive approach involving nurses in multidisciplinary teams to air quality self-management. They can use these results to inform their interventions and ways of knowing, benefiting individuals with asthma and COPD. Further research is needed to expand the evidence base and refine these interventions.
- Algorithm for transitional care for caregivers of dependent older adults: a validation studyPublication . Gomes, Thawanna; Ferreira, Bruna; Baixinho, Cristina Lavareda; Ferreira, Óscar Manuel RamosObjective: To construct and validate an algorithm for transitional care for caregivers of dependent older adults. Method: This was a methodological study developed in three phases: a literature review, designing an algorithm, and its validation by a peer panel with twenty seven experts selected according to pre-defined inclusion criteria. Results: The algorithm predicted interventions in transitional care (hospital stay, at discharge, and 30 days at home post-discharge) aimed at the exercise of the caregiver role; needs assessment; training in care management of dependent older adults and management of self-care, and ensuring continuity of care (of older adults and caregivers). Conclusion: Agreement between expert raters and a reliability test of 0.92 indicate that the algorithm can be used by professionals to decide the transitional care interventions to be administered to the caregivers of dependent older adults. Future studies should be conducted to perform its clinical validation.
- Analyzing innovative policies and practices for palliative care in Portugal: a qualitative studyPublication . Silva, Marcelle Miranda da; Telles, Audrei Castro; Baixinho, Cristina Lavareda; Sá, Eunice; Costa, Andreia; Henriques, Maria Adriana PereiraBackground Countries with formal policies for palliative care, and advanced and integrated practices in this field, such as Portugal, face challenges in achieving excellence in care, particularly in home-based assistance. Issues include care coordination among providers, confusion regarding the roles of each health care professional in the network, and a lack of monitoring and evaluation of actions. Our objective was to analyze the implementation of palliative care in primary health care in Portugal. Methods We conducted a qualitative, descriptive, and exploratory study in Portugal involving health care professionals with experience in palliative care. The data were collected through semistructured interviews and focus groups between March and October 2023. Eighteen health care professionals participated. We used the Alceste software for lexicographic analysis. The research was authorized by an Ethics Committee. Results Four classes were identified; classes 1 and 2, comprising 77% of the corpus, addressed the study objectives. Participants highlighted inequitable access, strategic development plans with unattainable short-term goals; and low literacy. They emphasized the importance of legislation, professional training initiatives for generalist palliative care at home, and early referral. Home-based challenges included professionals’ lack of exclusive dedication, absence of 24/7 coverage, and unavailability of capable family caregivers. The networks’ response to hospital admissions and patient transitions from hospital to home, with access to the specialized team, was also inadequate. Conclusions Health care professionals aim to increase patients’ time spent at home, reduce emergency department visits, and minimize hospitalizations by leveraging the resources of the national palliative care network. In addition to investments to sustain network implementation and legally guaranteed palliative care rights, the country must focus on measurable indicators for evaluating and monitoring actions, providing better guidance in the short, medium, and long term.
- Applying mHealth for assessment of complex wounds: insights from a focus groupPublication . Marques, Raquel; Mira, Helena I. M. F.; Lopes, Marcos V. O.; Neves-Amado, João D.; Ramos, Paulo A. S.; Alves, Paulo J. P.It is a reality of care praxis that it is difficult for healthcare professionals to assess and monitor the local status of wounds objectively and regularly. This study aims to identify the minimum data required to evaluate patients with complex wounds to be incorporated into mHealth. Methods. Descriptive qualitative study, based on thematic analysis, using the online focus group technique. An intentional sample was selected, and two separate sessions were held, attended by 6 experts and 7 nurses. The data were coded by two researchers, with a deductive method, using NVivo software. Results. 5 themes emerged which are described as follows: assessment of patients with complex wounds, distinctive criteria based on the type of wound, flowcharts for approaching patients with wounds, characteristics of a mobile application focused on wound care, and alerts to be included in a mobile health application dedicated to wound treatment. The theme characteristics of a mobile application for approaching the patient with wounds raised 4 subthemes: (1) image, (2) communication, (3) decision-making, and (4) safety. Conclusion. The use of wound assessment tools provides data capable of generating quality care outcome indicators. These serve as good practice guides, enhancing health gains, whether they are economic or quality-of-life improvements.
- Aquisição de competências parentais da grávida adolescente institucionalizadaPublication . Presado, Maria Helena; Monteiro, Sandra VarelaA gravidez na adolescência é considerada um problema de saúde pública, embora a taxa de fecundidade neste grupo etário tenha diminuído, em Portugal no ano de 2022 existiram 6,2 ‰ de grávidas adolescentes. Algumas, sem apoio familiar e numa situação de vulnerabilidade acrescida; residem em instituições de acolhimento, levando a grávida a necessitar de uma intervenção psicossocial para o desenvolvimento de competências pessoais e parentais fundamentais para o desempenho do papel de mãe. O apoio social, é fundamental para proteger a grávida e a criança, prevenir comportamentos de risco e promover o desenvolvimento de competências parentais, facilitando o processo de transição para a parentalidade. O número insuficiente de funcionários das instituições sociais e de saúde, tem um impacto negativo no desenvolvimento das suas competências pessoais, socias, profissionais ou parentais das grávidas adolescentes. Objetivo: conhecer o processo de aquisição de competências parentais da grávida adolescente institucionalizada. Métodos Estudo exploratório, descritivo de abordagem qualitativa, com recurso a entrevista a sete grávidas adolescentes residentes em três instituições de acolhimento. Resultados: A análise de conteúdo do relato das experiências de vida de 7 participantes revelam, medo e insegurança. Consideram importante o apoio do enfermeiro na gravidez para a aquisição de competências parentais através da integração de programas de preparação para o parto e parentalidade. Revelam falta de apoio no pós-parto. Salientando, o importante o apoio das técnicas da instituição de acolhimento. Conclusões. As grávidas adolescentes necessitam de apoio psicossocial, uma vigilância da gravidez e de um acompanhamento no pós-parto mais adequada às necessidades. É imperioso uma maior articulação e complementaridade entre os serviços de saúde e sociais.
- Assessment of rehabilitation nurses' knowledge and results of nurse educational programme (C2F) regarding osteoporosis and fragility fracturesPublication . Pimentel, Georgina; Cruz, Arménio; Baixinho, Cristina Lavareda; Loureiro, Maria; Fernandes, Silvia; Ferreira, Ricardo J.O.; Marques, AndréaBackground: Providing adequate care for the person with a fragility fracture is essential to prevent recurrences. A key strategy involves training by improving nursing care in the fields of osteoporosis and fragility fractures. However, in Portugal, there is no report on the level of knowledge of nurses, nor experimental studies on how to improve it. Objective: The study aimed to assess the knowledge of Rehabilitation Nurses in Portugal on osteoporosis and fragility fractures. Additionally, it sought to evaluate the impact of a specific educational programme on nurses' knowledge. Methods: In Phase I, a cross-sectional study involved 452 participants, utilizing a 26-question knowledge test. In Phase II, a quasi-experimental study included 42 nurses from 28 hospitals, subjected to a 30-h hybrid educational programme. The program comprised 9 online (2 h 30 min each) and 2 live sessions, covering assessment, pharmacological and non-pharmacological treatment, monitoring, project planning, consultations, and outcome indicators measurement. A before-and-after programme knowledge test was administered. Results: Phase I revealed an average knowledge score of 69.6%. In Phase II, there was a significant improvement with programme (70.4% vs. 85.8%, p < 0.01). Specialized nurses performed better than non-specialized nurses (80% vs. 75%, p = 0.011), and those from orthopaedic services showed the greatest improvement (92% vs. 83%, p = 0.014). Conclusions: Rehabilitation Nurses in Portugal have room to improve their knowledge of osteoporosis and fragility fractures. The hybrid educational programme proved effective in improving nurses' knowledge, especially among specialist and orthopaedic service nurses. We hope that this knowledge can be translated into continuous improvement in healthcare provision.
- Autoavaliação de soft skills em enfermagem: construção e validação de conteúdo de um instrumentoPublication . Beltran, Rebeca Iwankiw Lessa; Figueiredo, Karla Crozeta; Peres, Aida Maris; Nunes, Elisabete Maria Garcia TelesObjetivo Construir e validar um instrumento para autoavaliação de soft skills em liderança autêntica de enfermagem. Métodos Pesquisa metodológica desenvolvida em três etapas: revisão de literatura, elaboração do instrumento intitulado “LEADERSKILLS” e validação de conteúdo do instrumento com experts, usando a Técnica Delphi Online. A primeira etapa foi composta por duas revisões narrativas. A segunda etapa incluiu um teste piloto ao desenvolvimento do instrumento contendo a descrição narrativa das soft skills mais relevantes (relacionadas ao exercício da liderança autêntica do enfermeiro) que foram apresentadas pela revisão narrativa da literatura. A terceira e última etapa incluiu a alteração do instrumento após as considerações realizadas pelos experts. Resultados O painel de experts da primeira rodada foi composto por 13 participantes. Das 17 questões de múltipla escolha avaliadas na primeira rodada, só duas (pertencentes aos componentes conteúdo e linguagem) não obtiveram Índice de Validade de Conteúdo (IVC) ≥0,85. A primeira questão era sobre a compreensão inadequada do que seriam os títulos e subtítulos do “LEADERSKILLS” e a segunda era sobre clareza e objetividade do instrumento. As principais sugestões dos juízes estavam concentradas nos componentes conteúdo, linguagem e layout. A segunda rodada foi composta pela resposta de cinco experts, sendo possível alcançar o consenso das questões obtendo IVC ≥0,80. Conclusão O instrumento construído para desenvolver soft skills em enfermagem foi considerado válido quanto ao conteúdo, layout, linguagem, motivação e cultura, alcançando avaliação coerente e aplicabilidade ao público-alvo.
- Autogestão do diabetes na adolescência: experiência de jovens adultos e pais portugueses adolescênciaPublication . Malheiro, Maria Isabel Dias da Costa; Vinagre, Maria da Graça; Colaço, Sónia Isabel; Flora, Marília Costa; Paixão, Maria José Góis; Figueiredo, Inês Carnall; Dingle, MarinaObjective To identify the factors that facilitate or hinder the construction of autonomy in adolescence through the experience of young adults with type-1 diabetes and their parents. Methods This was a qualitative, descriptive, and exploratory study. Two focus group interviews were conducted: one with nine young adults who were experts in managing their illness and the other with seven parents. Thematic and categorical content analysis was used for data analysis, with particularities of a focus group interview and the use of the NVIVO 12 software. Results Two major categories and ten subcategories related to factors that facilitated (support systems, knowledge, diet, insulin pump, early responsibility for managing therapy, and characteristics of young people) and hindered (therapeutic regimen, stigma, attitude of health professionals, characteristics of young people, and knowledge) the development of autonomy in disease management emerged. Conclusion Autonomy in the management of diabetes involves several challenges for adolescents, which requires adaptation of attitudes and interventions by professionals. In addition to the traditional management of the health condition, addressing issues related to the socialization of adolescents is essential, looking for innovative strategies that promote coping and quality of life. The results of this study make it possible to reflect on the therapeutic relationship with adolescents, emphasizing the importance of individualizing care and innovative responses to their specific needs. type1 type 1 type- parents qualitative descriptive conducted software support systems knowledge diet pump therapy people regimen stigma professionals emerged condition essential life needs